Transcript Avoiding Gluten and Cross Contamination

Celiac Disease
The Gluten-Free Diet
and
The Prevention of Cross-Contamination
General Information Programs
Avoiding Gluten and Cross Contamination
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The Nature of Celiac Disease
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Celiac Disease is an autoimmune
disease.
It is one of the most common
autoimmune diseases.
The autoimmune response occurs in the
gut.
It is triggered by Gluten, a storage
protein in wheat, barley and rye.
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The Nature of Celiac Disease
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The onset of CD can occur at any age.
All people diagnosed with CD will have
intestinal damage.
The villi become inflamed, flattened and
disappear.
Nutrients, including carbohydrates,
proteins, fats, vitamins and minerals,
can no longer be absorbed.
This leads to malnutrition and other
serious health problems.
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Frequency of Occurrence
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CD occurs in almost 1% of the
population.
CD occurs in 1 in 22 first degree
relatives.
CD occurs in 1 in 39 second degree
relatives.
CD occurs in 1 in 56 people with gastrointestinal symptoms.
CD occurs in 1 in 133 of the ‘not at risk
population.
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Treatment of CD
The only treatment for Celiac Disease is a
STRICT GLUTEN-FREE DIET
FOR LIFE
Even small amounts of gluten can be
harmful to people with Celiac Disease
and can cause continued small bowel
damage.
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What Happens When We’re
Glutened?
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The accidental ingestion of gluten does
not cause the profound anaphylactic
response that is common with peanuts
and other allergens.
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What Happens When We’re
Glutened?
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Many people with CD will have
immediate intestinal symptoms.
Many will have headaches or other nonintestinal symptoms.
Many will have delayed symptoms.
Many will have no symptoms but will
still have intestinal damage which can
lead to other illnesses.
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What Happens When We’re
Glutened?
The progression of
damage to the
villi
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What Happens When We’re
Glutened?
Avoiding Gluten and Cross Contamination
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What Happens When We’re
Glutened?
Avoiding Gluten and Cross Contamination
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Major Concerns
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Increase Awareness
Safe Ingredients
Hidden Sources of Gluten
CROSS CONTAMINATION
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Gluten Containing Grains &
Grain Products
Barley
Couscous
Emmer
Graham flour
Oats*
Semolina
Wheat
Bulgar
Durum
Filler
Kamut
Roux
Spelt(Dinkel)
Cereal Binding
Einkorn
Farro
Malt
Rye
Triticale
Oats are currently excluded from the gluten-free diet because of the high risk of contamination from gluten
containing grains
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Gluten-Free Grains &
Grain Substitutes
Amaranth
Cassava
Flax
Nuts
Potatoes
Sago
Tapioca
Arrowroot
Corn (Maize)
Legumes
Poi
Quinoa
Sorghum
Teff
Avoiding Gluten and Cross Contamination
Buckwheat
Dahl
Millet
Polenta
Rice
Soy
Wild Rice
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Other Gluten-free Foods
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Fresh meat, poultry, fish and seafood
Fresh vegetables and fruits
Eggs
Cheese and other dairy
All products made with gluten-free
ingredients
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The Questionable Products
Baking powder
Bouillon cubes
Condiments
Dry roasted nuts
Herbal teas
Ice cream and yogurt
Imitation seafood
Marinades and sauces
Pilaf mixes
Puddings
Salad dressing
Seasoned fries
Smarties*
Soy sauce
Avoiding Gluten and Cross Contamination
Beverage mixes
Cheese spreads
Dried fruit
Flavourings
HPP/HVP
Icing sugar products
Licorice and candies
Modified food starch
Processed meats
Rice and soy beverages
Seasonings
Self basting poultry
Soups and broths
Worcestershire sauce
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Preventing Contamination &
Cross-contamination
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When preparing a gluten-free meal, it is
important to prevent contamination of
the gluten-free foods with glutencontaining food particles and residues.
Even small amounts of gluten can result
in continued intestinal damage for people
with CD and DH
Care must be taken to ensure that
gluten-free foods remain gluten-free.
Avoiding Gluten and Cross Contamination
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Preventing Contamination &
Cross-contamination
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Select a preparation area that is
separate from other food preparation
areas.
Air-borne flour and other glutencontaining particles can contaminate
gluten-free foods.
Ensure all preparation surfaces, cooking
surfaces and cooking utensils have been
thoroughly cleaned, including counter
top, meat slicer, grill surface, cutting
boards, bowls, knives, utensils,
thermometers, cleaning cloths.
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Preventing Contamination &
Cross-contamination
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Use dedicated pots, pans, utensils and
cutting boards whenever possible.
Rolled edge pans are easier to clean.
Scrub with soap and water to ensure removal of gluten-containing particle. Disinfect
according to current standards of practice.
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Preventing Contamination &
Cross-contamination
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Follow impeccable hand washing
practices.
Use sanitary gloves for food preparation
and change them before handling GF
foods.
Ensure the powder used is gluten-free.
Even powder-free gloves can have trace
amounts of powder.
Become knowledgeable about special
needs diets and menu selections.
Educational programs are offered through many of the local chapters of the Canadian Celiac
Association.
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Preventing Contamination &
Cross-contamination
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Ensure all ingredients are gluten-free.
Check product ingredients
regularly. Manufacturers and suppliers
can change ingredients without notice.
Ensure that anti-caking and flow agents
are GF. These agents may not be
identified in the ingredient lists.
Use boldly labeled, air tight containers
for all products designated as GF.
Prepare GF meals before other menu
selections
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Preventing Contamination &
Cross-contamination
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Clean utensils must be used for each
condiment, butter, sauce and all other
items.
Use individual portions and/or squeeze
bottles.
Deep fryer oil previously used for glutencontaining foods is unsafe for gluten-free
cooking.
Fresh water must always be used for
boiling, poaching or steaming.
Avoiding Gluten and Cross Contamination
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Preventing Contamination &
Cross-contamination
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Use the top oven racks.
Use caution with convection ovens.
Use toaster bags to prevent
contamination of GF bread products.
Arrange buffet tables with gluten-free
selections first and separated from the
gluten-containing selections. Label them.
Bulk bins can be a source for crosscontamination.
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Using Safe Alternatives
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Many common food products have safe
alternatives: Eg. Soy sauce.
Safe thickening agents can be used in
place of flour: Eg. Potato starch, tapioca starch.
Select pure spice blends rather than
seasoning blends that may contain
gluten-containing fillers.
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Using Safe Alternatives
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Many foods start out gluten-free and are
glutened in menu preparation: Eg. Salads
Many food items have gluten-free
alternatives: Eg. Pizza shells, pasta
Develop clearly identified gluten-free
alternatives as part of a standard menu.
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For More Information
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Our website: www.calgaryceliac.com
National website: www.celiac.ca
Links to other chapter and resource
websites
Email: Jo Anne Murray
[email protected]
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www.calgaryceliac.com